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      Vulnerability, Moral responsibility, and Moral Obligations: the case of Industrial Action in the Medical and Allied Professions

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          Abstract

          The article addresses issues at the nexus of physician industrial action, moral agency, and responsibility. There are situations in which we find ourselves best placed to offer aid to those who may be in vulnerable positions, a behavior that is consistent with our everyday moral intuitions. In both our interpersonal relationships and social life, we make frequent judgments about whether to praise or blame someone for their actions when we determine that they should have acted to help a vulnerable person. While the average person is unlikely to confront these kinds of situations often, those in the medical professions, physicians especially, may confront these and similar situations regularly. Therefore, when physicians withhold their services for whatever reason in support of industrial action, it raises issues of moral responsibility to patients who may be in a vulnerable position. Using theories of moral responsibility, vulnerability, and ethics, this paper explores the moral implications of physician industrial action. We explore issues of vulnerability of patients, as well as the moral responsibility and moral agency of doctors to patients. Determining when a person is vulnerable, and when an individual becomes a moral agent, worthy of praise or blame for an act or non-action, is at the core of the framework. Notwithstanding the right of physicians to act in their self-interest, we argue that vulnerability leads to moral obligations, that physicians are moral agents, and the imperatives of their obligations to patients clear, even if limited by certain conditions. We suggest that both doctors and governments have a collective responsibility to prevent harm to patients and present the theoretical and practical implications of the paper.

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          Most cited references78

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          On the remarkable persistence of asymmetry in doctor/patient interaction: a critical review.

          Doctor/patient interaction has been the object of various reform efforts in Western countries since the 1960s. It has consistently been depicted as enacting relationships of dominance or oppression. Most younger medical practitioners have received interaction skills training during their professional education, intended to encourage more equal forms of consultation behaviour. However, the evidence that 'patient-centredness' has a positive impact on health outcomes is at best mixed. At the same time, empirical studies of consultations point to the remarkable persistence of asymmetry. These two factors together suggest that asymmetry may have roots that are inaccessible to training programmes in talking practices. Illustrating our argument with findings from conversation analytic studies of doctor/patient interaction, we suggest that asymmetry lies at the heart of the medical enterprise: it is founded in what doctors are there for. As such, we argue that both critical and consumerist analysts and reformers have crucially misunderstood the role and nature of medicine. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            Alternate Possibilities and Moral Responsibility

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              Moral disengagement: How people do harm and live with themselves

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                Author and article information

                Contributors
                Henry.Adobor@quinnipiac.edu
                Journal
                Med Health Care Philos
                Med Health Care Philos
                Medicine, Health Care, and Philosophy
                Springer Netherlands (Dordrecht )
                1386-7423
                1572-8633
                1 August 2022
                : 1-17
                Affiliations
                GRID grid.262285.9, ISNI 0000 0000 8800 2297, Department of Strategy, Entrepreneurship & International Business, School of Business, , Quinnipiac University, ; 275 Mount Carmel Avenue, 06518 Hamden, CT USA
                Author information
                http://orcid.org/0000-0001-9356-7513
                Article
                10078
                10.1007/s11019-022-10078-z
                9342840
                35915369
                9c44b812-ae0d-4689-ae68-52eb7817a3ac
                © The Author(s), under exclusive licence to Springer Nature B.V. 2022

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 16 December 2021
                : 2 February 2022
                : 23 March 2022
                Categories
                Scientific Contribution

                Medicine
                doctors’ strike,vulnerability,moral responsibility,moral agency,the duty of care
                Medicine
                doctors’ strike, vulnerability, moral responsibility, moral agency, the duty of care

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